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    • Provider Relations Representative, Consultant - Los Angeles - Blue Shield of CA

    Blue Shield of CA
    Blue Shield of CA Los Angeles

    1 month ago

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    Description

    The Provider Relations Consultant plays a pivotal role in Blue Shield of California's CalPERS line of business programs, focusing on supporting Plan to Plan operations and building effective provider relationships.

    Your Responsibilities

    • Implement strategies with providers to improve performance and compliance with company policies and contractual agreements.
    • Develop and maintain strong working relationships with the provider community, facilitating communication and resolving questions or problems.
    • Serve as liaison between Blue Shield and the provider community, ensuring smooth contract interpretation, product/program implementation, and claims administration.
    • Identify potential network participants and promote provider participation in Blue Shield programs and networks to enhance the company's competitive position.
    • Conduct provider orientations, communicating company policies, procedures, products, or services.
    • Aid with provider negotiations and may negotiate selected agreements.
    • Manage complex provider relationships and function as the primary contact while showing the ability to influence providers and build strong provider relationships.

    Your Requirements

    • Requires a college degree or equivalent experience.
    • Requires 7 years of prior relevant experience.
    • Minimum 3 years of prior relevant experience in Provider Relations.
    • Excellent analytical and critical thinking skills are preferred.
    • The ability to build strong relationships both internally and externally.
    • Knowledge of provider contracting process is preferred.
    • Experience of onboarding providers is preferred.
    • Experience in provider outreach.
    • Ability to manage multiple projects is preferred.
    • Effective communication skills.

    Your Compensation

    The estimated annual salary for this role ranges from $96,470.00 to $144,760.00 based on location in California, taking into account factors such as experience, location (California, Bay area, or outside California), and current employee salaries for similar roles at Blue Shield.

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